The URL can be used to link to this page

Home My WebLink About211468 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1 ONE CIVIC SQUARE ST VINCENTS EMPLOYEE ASSISTANCEACK AMOUNT: $2,980.05 s•.�,a CARMEL, INDIANA 46032 8401 HARCOURT ROAD INDIANAPOLIS IN 46260 CHECK NUMBER: 211468 CHECK DATE: 7/31/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4347500 057403027 2 , 761 . 50 GENERAL INSURANCE 1125 4340700 57403017 218 . 55 MEDICAL FEES ST VINCENT EMPL. ASST. PROGRAM 8401 HARCOURT RD INDIANAPOLIS IN 46260 Date Account Number Balance 07/11/12 5-20376299 2761. 50 *CITY OF CARMEL. LAMB, BARB CITY HALL 1 CIVIC SQUARE CARMEL, IN 46032 Please enclose top portion with payment Rate : 1 . 75 Number of Employees : 526 ACCT # : 5-20376299 PATIENT: *CITY OF CARMEL. CHG. AMT PAY/ADJ BALANCE INVOICE # : 057403027 EMP PROVIDER 07/06/12 JULY 2012 920 . 50 07/06/12 AUGUST 2012 920 . 50 07/06/12 SEPTEMBER 2012 920 . 50 INVOICE BALANCE: 2761. 50 F D Q � JUL 3 0 2012 By Account 0-30 days 31-60 days 61-90 days >90 days Balance Due 5-20376299 2761 . 50 0 . 00 0 . 00 0 . 00 2761 . 50 PAGE: 1 ST VINCENT EMPL. ASST . M - F 9a.m. to 4p.m. 8401 HARCOURT RD Ph: 317-338-4900 INDIANAPOLIS IN 46260 Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) 07/11/12 057403027 $2,761.50 1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 St. Vincent Employee Assistance Program IN SUM OF $ 8401 Harcourt Rd Indianapolis, IN 46260 $2,761.50 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 057403027 43-475.00 $2,761.50 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Moggay, July 30, 2012 Director, Xdministratig Title Cost distribution ledger classification if claim paid motor vehicle highway fund St. Vincent Stress Centers ST. VINCENT STRESS CENTER Amount Due: $218.55 ST. VINCENT EAP Amount Paid: 8401 Harcourt Road INDIANAPOLIS, IN 46260 A/R Account# 3-1000-1130-00 Date Account Number 07/13/12 5-20386066 Invoice#057403017 Carmel Clay Parks & Recreation Attn: Lynn Russell 1411 E. 116th Street Carmel, IN 46032 To ensure proper credit to your account, please enclose top portion of this invoice with your payment. St. Vincent Stress Centers A/R Account# 3-1000-1130-00 Rate No. of Employees ST. VINCENT STRESS CENTER $2.35 31 ST. VINCENT EAP 8401 Harcourt Road INDIANAPOLIS, IN 46260 Date Description Units Amount July EAP Services 1 $72.85 2012 August 2012 EF Services ``�`'�%�' ° 1 $72.85 , -. p �,�Q�;; "zmber EAP Services 1 $72.85 ✓✓2012 Purchase Y I C L ED Description LA P 5 erVices P.O.# PorF JUL 17 2012 U.L.# l 1�,5 �-o I- 4'ND-100 sudcet Lime bescrffl�jeo c�) Purchaser Date ?,pproval Date / 7L_ Total $218.55 For questions regarding this bill please call (317) 338-4900. ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly itemized must show; kind of service,where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. 295900 St. Vincent Stress Center Terms 8401 Harcourt Road Date Due Indianapolis IN 46260 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 7/13/12 57403017 Employee Assistance Program Jul-Sep'12 $ 218.55 Total $ 218.55 1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 . 20 Clerk-Treasurer Voucher No. Warrant No. 295900 St. Vincent Stress Center Allowed 20 8401 Harcourt Road Indianapolis IN 46260 In Sum of$ $ 218.55 i ON ACCOUNT OF APPROPRIATION FOR 101 - General Fund PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1125 57403017 4340700 $ 218.55 bill(s) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 26-Jul 2012 P&ikL� Signature $ 218.55 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund